Role of Surgery in locally advanced prostate cancer

A significant proportion of patients present with locally advanced prostate cancer with inherent higher risk of local recurrence and systemic relapse after initial treatment. Recent literature favors combination of radiation therapy and extended hormonal therapy for this subset of patients. The effectiveness of Radical prostatectomy (RP) alone for locally advanced prostate cancer is controversial and is a focus of debate. However, it can decrease the tumor burden and allows the accurate and precise pathological staging with the need for subsequent treatment. Comparison of RP and other treatment modalities is difficult and incorrect because of inherent selection bias. RP as a part of multi-modality treatment (with neo-adjuvant hormonal therapy (HT) and with adjuvant or salvage radiation therapy (RT)/HT) can provide long term overall and cancer specific survival. Surgical treatment (such as transurethral resection (TUR), JJ stenting and percutaneous nephrostomy (PCN) placement etc.) can also provide symptomatic improvement and palliative care to improve quality of life of patients with advanced prostate cancer

Bayesian approach to classification of football match outcome

The football match outcome prediction particularly has gained popularity in recent years. It attract lots type of fan from the analyst expert, managerial of football team and others to predict the football match result before the match start.There are three types of approaches had been proposed to predict win, lose or draw; and evaluate the attributes of the football team. The approaches are statistical approach, machine learningapproach and Bayesian approach. This paper propose the Bayesian approaches within machine learning approaches such as Naive Bayes (NB), Tree Augmented Naive Bayes (TAN) and General Bayesian Network (K2) to predict the football match outcome. The required of football data is the English Premier League match results for three seasons; 2016 – 2017, 2015 – 2016 and 2014 – 2015 downloaded from http://www.football-data.co.uk. The experimental results showed that TAN achieved the highest predictive accuracy of 90.0 % in average across three seasons among others Bayesian approach (K2 and NB). The result from this research is hope that it can be used in future research for predicting the football match outcome

Functional and clinical outcome of ileal (Studer) neo-bladder reconstruction: Single centre experience from Pakistan

Objective: To determine the medium and long-term outcome of orthotopic continent urinary diversion with ileal (Studer) neo-bladder following radical cystectomy. Study Design: Case series. Place and Duration of Study: Department of Surgery, The Aga Khan University Hospital, Karachi, from January 1998 to September 2010. Methodology: Thirty eight patients underwent radical cystectomy for invasive bladder tumor with ileal neo-bladder (Studer type) reconstruction. Peri-operative and late complications, functional outcome of neo-bladder, urinary continence, metabolic and upper urinary tract status and overall survival were evaluated in all patients. Results: A total of 29 patients (23 males and 6 females) with mean age of 59 ± 12 years were included for the final analysis. The mean duration of surgery (both radical cystectomy and urinary diversion) was 520 ± 70 minutes. Perioperative complication rate was 24% (n=7) with surgical site infection in 4 patients, sepsis in 1 patient and 2 had ureteroileal leak. At 6 months follow-up, 22 patients were fully continent while 7 patients had minimal stress / nocturnal incontinence. The continence rate was 93% (n=27) at one year follow-up. The mean capacity of neo-bladder at 6 months was 384 ± 66 mLs. The late complication rate was 17% (n=5). Three patients developed anastomotic stricture requiring transurethral incision of neo bladder neck, one formed stone in neo-bladder and one developed incision hernia. All patients had preserved renal functions on follow-up. The survival rate was 80% (n=23) at a median follow-up of 66.4 ± 36 months. Two patients developed local recurrence and four developed distant metastasis. Conclusion: Studer ileal neo-bladder is a safe and effective option for urinary diversion in select patients with good oncological and functional outcomes comparable to contemporary literature, even in a low volume center

Mesin pembungkus nasi lemak

Pada era globalisasi ini, makanan tradisi melayu semakin berkembang dengan permintaan yang sentiasa meningkat saban tahun. Promosi hebat dan kesan media sosial telah menyebabkan tarikan yang kuat terhadap makanan tradisional Malaysia ditambah pula dengan kaedah hiasan yang kreatif dan menarik. Antara makanan tradisi melayu yang mendapat permintaan tinggi adalah Nasi Lemak. Nasi Lemak sangat sinonim dengan negara Malaysia sehinggakan ianya menjadi menu tetap sarapan pagi bagi setiap gerai mahupun hotel di negara kita. Penjualan nasi lemak sangat popular dan meluas. Permintaannya meningkat bukan sahaja di dalam negara, bahkan di peringkat antarabangsa juga nasi lemak mempunyai peminatnya yang tersendiri. Bagi syarikat penerbangan milik Malaysia seperti Airsia dan MAS, Nasi Lemak menjadi pilihan hidangan untuk penumpangnya yang terdiri daripada pelbagai warganegara serata dunia. Selain itu, faktor berlakunya peningkatan permintaan terhadap nasi lemak adalah kerana ianya tidak lagi hanya menjadi menu sarapan pagi semata-mata, malah ia juga menjadi menu makanan sepanjang masa sehingga ke lewat malam

Production of instant ‘nasi lemak’ flavour ingredient from palm olein

Instant ‘nasi lemak’ flavour ingredient was prepared by microencapsulation of palm olein and pandan leaf flavour. The pandan-flavoured encapsulated powder was obtained after spray drying using maltodextrin (DE15) and sodium caseinate as wall materials. Analysis of the encapsulated powder indicated that the moisture, oil and surface oil content were 2.17%, 68.1% and 20.5% respectively. Gas chromatographic analysis revealed that 78.57% pandan flavour was encapsulated in the powder

An unusual combination of extra-adrenal pheochromocytoma and arteriovenous malformation of the ureter in a young adult

We present a case of a 24-year-old gentleman who presented with painless pan haematuria for 2 weeks. During the workup, he was diagnosed to have a retrocaval mass after a CT scan while cystoscopy revealed a polypoidal pulsating lesion in the left ureter. After surgical manipulation of the retrocaval mass, the blood pressure of the patient raised to 260/130 mm Hg. It was completely resected and diagnosed as extra-adrenalpheochromocytoma (paraganglioma) after histopathology. The lesion in the ureter was completely excised and fulgurated and diagnosed as anarteriovenous malformation. To the best of our knowledge, this is the first patient to be presented in the literature with this unusual combination

Urdu version of the neck disability index: a reliability and validity study

Abstract Background Despite the wide use of the neck disability index (NDI) for assessing disability in patients with neck pain, the NDI has not yet been translated and validated in Urdu. The first purpose of the present study was to translate and cross-culturally adapt the NDI into the Urdu language (NDI-U). The second purpose was to investigate the reliability, validity and responsiveness of the NDI-U in Urdu-speaking patients experiencing chronic mechanical neck pain (CMNP). Methods Translation and cross-cultural adaptation of the original version of the NDI were carried out using previously described procedures. Seventy-six patients with CMNP and thirty healthy participants were recruited for the study. NDI-U and visual analogue scales for pain intensity (VASpain) and disability (VASdisability) were administered to all the participants at baseline and to the patients 3 weeks after receiving physiotherapy intervention. The global rating of change scale (GROC) was also administered at this time. Test-retest reliability and internal consistency were carried out on forty-six randomly selected patients two days after they completed the NDI-U. The NDI-U was evaluated for factor analysis, content validity, construct validity (discriminative and convergent validity) and responsiveness. Results An intra-class correlation coefficient (ICC2,1) revealed excellent test-retest reliability for all items (ICC2,1 = 0.86–0.98) and total scores (ICC2,1 = 0.99) of the NDI-U. The NDI-U was found internally consistent with a Cronbach’s alpha of 0.90 and a fair to good correlation between single items and the NDI-U total scores (r = 0.34 to 0.89). Factor analysis of the NDI-U produced two factors explaining 66.71% of the variance. Content validity was good, as no floor or ceiling effects were detected for the NDI-U total score. To determine discriminative validity, an independent t-test revealed a significant difference in the NDI-U total scores between the patients and healthy controls (P < 0.001). For convergent validity, Pearson’s correlation coefficient showed a strong correlation between NDI-U and VASdisability (r = 0.83, P < 0.001) and a moderate correlation between NDI-U and VASpain (r = 0.62, P < 0.001). To measure responsiveness, an independent t-test showed a significant difference in the NDI-U change scores between the stable and the improved groups (P < 0.001). Furthermore, moderate correlations were found between the NDI-U change scores and the GROC (r = 0.50, P < 0.001), VASdisability change scores (r = 0.58, P < 0.001) and VASpain change scores (r = 0.55, P < 0.001). Conclusion The results showed that the NDI-U is a reliable, valid and responsive questionnaire to measure disability in Urdu-speaking patients with CMNP

Rising China: Not at War with US

The rise of China is indeed no less than a miracle as the state has shown splendid economic growth in the period of few decades This rise has managed to attract the world wide attention While many in the contemporary world look at China as an opportunity the Western school of thought has portrayed it as nothing but a threat to the United States in particular Despite already having her allies in the region and a network of military bases other than the increasing economic relations with East Asian states United States has adopted measures to contain China China s behavior on the other hand shows that the state is more inclined towards the economic interdependence thereby creating a harmonious environment which will ensure world peace and stability Her regional policy shows that China not only wants to develop sound economic relations with all but also desires to sort out differences through dialogue and consensus China has by far avoided making alliances at both the regional and international level Furthermore China s growing economic relations with United States in particular point towards her peaceful ris